Carpal Tunnel Syndrome

Anti-inflammatory diet: eliminate gluten, dairy, sugar, processed foods (reduce systemic inflammation, swelling), focus on omega-3 foods (fatty fish 3-4x/week), colorful vegetables, berries, turmeric, ginger, leafy greens, B6-rich foods (chicken, turkey, fish, potatoes, bananas, chickpeas—but supplementation usually needed for therapeutic effect), avoid excessive protein (high protein intake may increase B6 requirements), adequate hydration (reduces fluid retention), If diabetic: strict blood sugar control (diabetic neuropathy worsens carpal tunnel), If pregnant: reduce sodium (decreases fluid retention), adequate protein, magnesium-rich foods, Weight loss if overweight (reduces inflammation, improves symptoms).

Ergonomic modifications CRITICAL: neutral wrist position when typing (wrist straight, not flexed or extended—use ergonomic keyboard, wrist rest), keyboard and mouse at elbow height, monitor at eye level (prevents neck/shoulder strain that worsens symptoms), frequent breaks (every 30-60 minutes—shake hands out, stretch), avoid prolonged gripping or repetitive hand movements, use tools with larger grips (reduces force needed), Night splinting (most important conservative treatment): wear wrist splint at night in neutral position (prevents wrist flexion during sleep—many people sleep with wrists curled, worsening compression), wear 4-8 weeks minimum, 70-80% improve with night splinting alone, some benefit from daytime splinting during activities that worsen symptoms, Nerve gliding exercises: specific exercises to mobilize median nerve, reduce adhesions, perform 3-5x/day, taught by physical therapist or hand therapist, Avoid: activities that worsen symptoms (prolonged gripping, forceful grasping, vibrating tools, sleeping on hands, extreme wrist flexion/extension), Weight loss if overweight (reduces symptoms), Stress management (stress increases muscle tension, worsens symptoms), Cold therapy (ice wrist for 10-15 min after activities that worsen symptoms—reduces inflammation), Corticosteroid injection into carpal tunnel: if conservative treatment insufficient after 6-12 weeks—provides temporary relief (3-6 months average), allows better participation in PT/ergonomic modifications, can repeat but limited number, 60-70% improve temporarily, Surgery (carpal tunnel release—cut transverse carpal ligament to decompress nerve): for severe carpal tunnel (thenar atrophy, constant numbness, weakness), progressive symptoms despite 6-12 months conservative treatment, positive Phalen's and Tinel's tests, abnormal nerve conduction studies—surgery highly effective (90-95% good outcomes), open or endoscopic approach (endoscopic faster recovery but slightly higher complication rate), risks (infection, nerve damage, scar tenderness, pillar pain, recurrence 5-10%, incomplete release), recovery 4-12 weeks, Many patients avoid surgery with: night splinting (most important), ergonomic modifications, vitamin B6, anti-inflammatory diet/supplements, nerve gliding exercises, corticosteroid injection if needed—worth trying before surgery, Pregnancy-related carpal tunnel: often resolves postpartum (fluid retention decreases)—night splinting, vitamin B6, avoid surgery during pregnancy unless severe.